The more ignorant you are, the more daring you are.
Ebola virus is not the only
disease that I have to worry about in Africa. There are something more than
this, the disease that I am fighting against to prevent right now: malaria,
dengue, chikungunya, and any other diseases from the mosquito. One consolation
in this sadness is that I should be fine for Yellow Fever because I already got
a vaccination against that 2 years ago, which is 10-year effective.
There are many mosquitoes
during the hot summer in South Korea too. However, they have no virus; the only
thing they bothered me was itchy mosquito bites area and their buzzing sound
right near my ears at night. Africa mosquitoes have a murder weapon in their
body; they transmit virus to another person, so no one can be free from their
attack. This is not like, “Oh, I have
some mosquito bite here! Haha…” You may die of malaria, dengue, and
chikungunya in Africa. How seriously would I feel aggrieved and mortified from
heaven if I were suddenly dead because of those bothering insects, mosquitoes?
I will not ever make that happen.
I am always interested in going
to tropical countries. A drop-dead sunlight makes me dizzy and giddy, but
strangely, it certainly arouses me verve, ardour, and first and foremost, gusto,
as much as burning weather! I like this energetic mind, so I have been to many
countries in the tropical zone, Taiwan, Thailand, Ghana, Sierra Leone, and now,
Tanzania. I never quail at the thought of being soaked in sweat because I can
take a shower with cold water. By the way, I will have only spent a winter
season in Tanzania, so my perennial memory about Tanzania in the distant future
would be shivering with cold, not bathing in the hot sun. In last term, I took
“Clinical and Epidemiological Aspects of Tropical Diseases” class, and I
suffered from memorizing unfamiliar names of many tropical diseases, such as Cysticercosis,
Schistosomiasis, Rickettsioses, Trypanosomiasis, Leishmania. The Korean names
of diseases were all mixed up with English in my head, so it was hard time for
me to distinguish which one was which. During the term, I was wondering how
many mosquito bites could actually cause malaria or dengue, so I asked the
question about Malaria prophylaxis in the online Discussion Forum. Dr. Margaret
Kosek answered all of my basic questions.
Q1. Some pharmacists argue that malaria pills are
not effective enough to prevent malaria, so it is better to take 4 pills at
once if there are suspected malaria symptoms, rather than take it everyday. Is
it true? How much we prevent malaria by taking pills on a regular basis?
A1. “Experts agree that although prophylaxis is
imperfect, it preferrable to "expectant management" strategies that
were used in the past.”
Q2. How much we have to be bitten by mosquitoes to
get malaria?
A2. “It depends on the sporozoite rate (the percent
of mosquitoes biting you that are infectious). If the rate is high (ie 10%) you
can predict a lower number of total bites are necessary than in situations
where only 1% of the mosquites are sporozoite positive. The rate of biting is
important as well- if the vectors only are present at a density of 3 bites per
hour, your risk is lower than if they bite you at a rate of 40/hr.”
Q3. If we stay in a malaria danger area for a long
time, for example 2 years, do we need to take malaria medicine for 2 years,
continually?
A3. “Cases for long term travelers are a bit more
individualized. In addition to malaria risk, the long term risk of retinopathy
due to chloroquine, and other toxocities related to other meds, change with
time exposed. The risk would also depend
on what prophlaxis you were taking, which is also a function of the drug
sensitivity profiles of malaria in the region. Also, long term travelers may
get pregnant, etc- and it is possible that their risk fluctuates over time and
some periods may not require prophylaxis. Long term travellers do also may
alternate regimes over time to avoid these cumulative type of toxicities.”
Also, one of classmates,
Alicia Majeau, introduced me an interesting article that explains about
parasite ratio, entomological inoculation rate, and rate of infectious
mosquitoes bites. Many mathematical concepts are included to know the complex
dynamics of Malaria. Even though I prepared chikungunya presentation for that
class and wrote about dengue policy in Mexico for “Global Disease Control
Programs and Policies” class, I did not ever realized how severe disease are
until I got here in Tanzania. I used to skip taking malaria pill while I was in
Thailand and Ghana because I was absolutely agnostic about the lethality of it.
From now, I will be less ignorant, and less daring to be exposed to mosquitoes.
<The entomological
inoculation rate and Plasmodium falciparum infection in African children>
As always, professional
dissertations make me frustrated, so I will just make the mosquito problem
simple and clear. Let’s prevent mosquito bite! I brought mosquito repellent
from the U.S., bought insect killer spray and raid in Tanzania, and I recently
received 윙윙ball and 모기119 from South Korea. So I have more than 3 different
type of killing or kicking mosquito out. 윙윙ball
and 모기119 were a bracelet/
anklet band style of insect repellent that I did not have to apply leery liquid
spray to my limbs. They included Citronella/ Chrysanthemum oil and released
fragrant smell. Their name sounded infantile, but I have to protect myself from
mosquito attacks! Am I excessively nervous? No, I cannot be too careful in
using all kinds of preventing swollen itchy bites. Even men with robust
physique die of mosquito, and I am still so shocked to recall the news; a
martial art – taekwondo – master from KOICA recently died of Dengue in
Tanzania. It only happened within 2 days; he went to hospital and found no
special disease, so he had no regard and took a rest at home. But it was
ascertained later that he contracted the Dengue fever – neither specific
medicine to treat nor vaccine until now – and passed from among us all of a
sudden. It is really regrettable, and I am sorry for our loss.
 |
| Go away, mosquitoes! |
Today, I came to Mundemu
ADP – the rural area that even satellite cannot catch – near to Makutapora. I
will stay here during this whole week. There is no running water, but good
thing is that Internet is so fast and food is three times a day! But at night,
the office was swarming with mosquitoes. I was freaked out. A flock of
mosquitoes were turning round and round over my head and whispering so
beautifully that they need me. Sorry, I do not need you. I wore childish
repellent ring on my wrist and ankle, but I came back to the bedroom 3 – the
place where was right across the office – to change to long-sleeved shirt and
wear socks, and shoot out insect spray for my small room. Although I was
clothes-armed to the teeth and came back to the office, mosquitoes were too
many there. I unwillingly came back to the room again, but now I am suffering
from horrible spray smells inside. The insects including mosquitoes in the room
are floundering on the floor, and the giant spider on the ceiling is still putting
on airs of its elegance. My first headache indicator has been just put in action. Oh
no, my headache… I really hope this headache will be gone tomorrow.
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